PubMed Health⌕ Search

Biomedical subjects

David R Finger

Publications and source records attributed to David R Finger.

10 recordsLinked to original sources
PubMed2006

Serial sonographic evaluation of Achilles tendons in patients taking fluoroquinolone antibiotics.

We performed a prospective study to determine if subclinical tendinopathy occurs in asymptomatic adults treated with fluoroquinolone antibiotics. Thirty-eight adults were enrolled. Serial ultrasounds of the Achilles tendons were performed. A board certified musculoskeletal radiologist interpreted the images in a blinded fashion. No changes were identified. Subclinical tendinopathy does not appear to exist in asymptomatic adults treated with fluoroquinolone antibiotics.

Achilles Tendon↗
PubMed2005

Falsely elevated cardiac troponin-I in patients with seropositive rheumatoid arthritis.

OBJECTIVE: To determine if patients with seropositive rheumatoid arthritis (RA) have abnormally elevated concentrations of cardiac troponin-I (cTnI). Reports suggest the presence of serum rheumatoid factor (RF) may interfere with the cTnI assay, leading to falsely elevated cTnI levels. One study reported a falsely elevated cTnI in 15 out of 100 serum samples with elevated RF using the Abbott assay, but no elevated level using the Bayer assay. It is unclear how many of these samples came from patients with RA. METHODS: Serum samples were drawn from 60 patients with seropositive RA. We measured RF and cTnI levels using both the Abbott AxSYM assay and the Bayer ADVIA Centaur assay. RESULTS: Of 60 RA patients with RF ranging from 15 to 2724 IU/ml, none was found to have an elevated cTnI on either assay. CONCLUSION: Using 2 commercial assays for cTnI, we found that patients with seropositive RA do not have falsely elevated serum cTnI levels.

Adult↗
PubMed2004

Beaver fever arthritis.

Giardia lamblia, a flagellated protozoan and common cause of gastroenteritis, is a rare but previously reported cause of reactive arthritis (ReA). We report a case of inflammatory oligoarthritis in a young woman after infection with Giardia. Two weeks after being treated, she developed an inflammatory arthritis of her left knee and right elbow that was refractory to nonsteroidal antiinflammatory medication. Antinuclear antibody, rheumatoid factor, and HLA-B27 tests were negative. She had almost immediate relief with intraarticular injection of corticosteroids. We review the previously reported cases of ReA following giardiasis and discuss possible pathogenic mechanisms. Although ReA most commonly occurs after chlamydial urethritis or gastroenteritis associated with typical enteropathic bacteria, important historical clues could point to less common pathogens such as Giardia. Physicians should be aware of these less common causes of ReA, because this could have important diagnostic and therapeutic implications.

Journal Article↗
PubMed2004

Spontaneous pneumothorax in scleroderma.

We present an illustrative case of a patient with advanced scleroderma who presented with a spontaneous pneumothorax, a condition that has only rarely been reported previously in association with scleroderma. Our patient and those previously reported had advanced pulmonary fibrosis with honeycombing and subpleural cysts, with spontaneous pneumothorax occurring secondary to cyst rupture. Our patient was treated with chest tube thoracostomy, but her spontaneous pneumothorax later recurred. She was then treated with talc pleurodesis and has not had a recurrence in 18 months of follow-up.Spontaneous pneumothorax remains a rare pulmonary manifestation of scleroderma, occurring only in patients with advanced pulmonary fibrosis associated with cyst formation and rupture. Initial management consists of chest tube insertion, but recurrence is high and may require pleurodesis or partial lobectomy. Physicians managing patients with scleroderma should be aware of spontaneous pneumothorax, especially in those with advanced pulmonary fibrosis and subpleural cysts.

Journal Article↗
PubMed2004

Catastrophic antiphospholipid syndrome; a "CATASTROPHIC" case of systemic lupus erythematosus.

Less than 1% of patients with the antiphospholipid antibody syndrome (APS) can develop multiple, simultaneous organ-system thromboembolic disease, which is referred to as the catastrophic antiphospholipid antibody syndrome (CAPS). Roughly one-half of these patients have systemic lupus erythematosus (SLE). Factors known to precipitate CAPS include infection, surgery, trauma, neoplasia, anticoagulation withdrawal, obstetric complications, and SLE flares. Optimal treatment includes anticoagulation and high-dose corticosteroids, although IVIG and plasma exchange may also have a role. The overall mortality of CAPS is roughly 50%, but prompt clinical recognition of this rare but devastating syndrome may lead to improved outcomes.

Adult↗
PubMed2002

Disseminated Histoplasmosis Mimicking Felty's Syndrome.

The successful treatment of rheumatoid arthritis often requires the use of immunosuppressive medications. Although these agents have different potential toxicities, they share in common the potential for permitting the development of opportunistic infections. We describe 2 patients with chronic rheumatoid arthritis treated with immunosuppressive agents who developed progressive neutropenia with documented splenomegaly. The differential diagnosis included Felty's syndrome versus bone marrow suppression from their immunosuppressive medication. Although both patients had the triad of Felty's syndrome, high titer seropositive rheumatoid arthritis with splenomegaly and neutropenia, the diagnosis of this syndrome relies on excluding other potential causative factors. Further investigation revealed that both patients had disseminated histoplasmosis with bone marrow involvement, which most likely represented reactivation from prior exposure to Histoplasma capsulatum. Opportunistic infections such as disseminated histoplasmosis can mimic other disease processes, including Felty's syndrome, and are important to consider when there is a change in the clinical status of patients with rheumatic disease who are immunocompromised.

Journal Article↗